To identify issues during donning and doffing of personal protective equipment (PPE) for infectious diseases and to inform PPE procurement criteria and design.

DESIGN

A mixed methods approach was used. Usability testing assessed the appropriateness, potential for errors, and ease of use of various combinations of PPE. A qualitative constructivist approach was used to analyze participant feedback.

Participants (n=82) were representative of the potential users of PPE within Western healthcare institutions.

RESULTS

None of the tested combinations provided a complete solution for PPE. Environmental factors, such as anteroom layout, and the design of protocols and instructional material were also found to impact safety. The study identified the need to design PPE as a complete system, rather than mixing and matching components.

CONCLUSIONS

Healthcare institutions are encouraged to use human factors methods to identify risk and failure points with the usage of their selected PPE, and to modify on the basis of iterative evaluations with representative end users. Manufacturers of PPE should consider usability when designing the next generation of PPE.

11.CDC. Guidance on personal protective equipment (PPE) to be used by healthcare workers during management of patients with confirmed Ebola or persons under investigation (PUIs) for Ebola who are clinically unstable or have bleeding, vomiting, or diarrhea in U.S. CDC website. http://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html. Updated August 27, 2015. Accessed December 2, 2015.

12.WHO. Guidance for donning and doffing personal protective equipment (PPE) during management of patients with Ebola virus disease in U.S. hospitals. WHO website. http://www.cdc.gov/vhf/ebola/hcp/ppe-training/. Published 2014. Accessed December 2, 2015.